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JUN-17-2003 111 52 952 476 7991 P.01^0 <br />A • <br />\ <br />• • • •• • <br />RJBQUmED SUBMITTALS <br />1. <br />2. <br />/. <br />4. <br />5. <br />n 6. <br />7. <br />8. <br />’"‘DCompleted ^plication Fonn "" * <br />' Certified Property Owner* List of owners within 150'. labels and plat map (you must <br />obtsis fhi? list, libels and dip fiosi Hesnspm County Oepaitmenc or jrmance A-fi03 <br />Govt Center, 348<5910). a ow. <br />Certificate of Survey (signed by a licensed surveyor) and include hardcover <br />calculations as retired. In addition, provide one (1) copy 8H" x 11" for <br />reproduction. <br />Topographic survey (existing and proposed elevations) if any changes in existing grade <br />arc proposed. In addition, provide one (1) copy 8Vi" x 11" for. reproduction. <br />Sketches or plans of floor it elevation ^devvs (provide one (I) copy 85^" x 11"). <br />List of the legal names (include marital status) of all persons with an interest in the <br />property. This would include nmc{s) of applicants) if not cmrent osmer(s). <br />As an addendum to this application, please attach a separate list of any other persons <br />you wish notified of this application. <br />Additional items as may be requested by City staff. <br />The Applicant and Property Owner must sign this application. Please remember that vour <br />variAOga applicaticq U Pot complete if the above iuforaiflflop net <br />APPLICANT'S SIGNATURE <br />T^e ^plicant hereby agrees to provide ell infonnaticn required requested by the Zoning <br />Admimstrator, agrees to pay ^dttional fees (staff time not cover i original fee payment) and/or <br />Applicant’s Signature Date a ? <br />OWNER'S SIGNATL.^ <br />The owner hereby acknowledges and agrees to this appIicaM:.-. i^d fu*ti;er euthoii2.s reasonable <br />commissionmembers for piuposes of mvestigauon and verification of this request. <br />Date ^afo3 <br />hiJl .n* scheduled meeting, please make amngements to <br />““ “ Office of thi. <br />% • <br />• v^ ^ /y o 'o